Reflections on “The Selling of Attention Deficit Disorder”

I found “The Selling of Attention Deficit Disorder” by Alan Schwarz, December 14, 2013 on the front page of the New York Times, a courageous article. If only it could have been published years ago. In general it is difficult to get such an article published because drug companies are so powerful, they put a lot of advertising pressure on publications. As a practicing psychiatrist for forty years, I take the condemnation of the use of amphetamines a step further.

There is no place for the use of amphetamines in psychiatry or medicine, never mind for children. Call it by any other name, it is still “speed”. It was discredited in the 1980’s after an earlier period of abuse as an anti-depressant and diet pill. It was mostly used as a street drug. Our in-patient wards were filled with amphetamine psychoses and addiction. It was originally concocted by the Nazis who used it for its soldiers during the Blitzkrieg and for its pilots in the bombing of Britain. It does generate a robotic push for everyone, before its untoward drug effects kick in.

But then a strange thing happened. A new medical-psychiatric genetic brain disease got invented: ADHD. And what was the treatment of choice? You guessed it. Suddenly, speed was safe again, non-addictive, no side effects, and it didn’t generate psychoses anymore. Its sordid history went right back into amnesia. Apparently, the past didn’t happen, so we certainly don’t have to learn from it. There is no credible and definable criteria in the brain for ADHD. Yes there are certain kids with an active temperament. If they do not have the proper boundaries and discipline at home they will spin out of control. These kids do not need speed. They need proper interventions in the family so they will go back into balance and be happy and productive kids. They do not have a disease. They will grow up naturally to be part of the wonderful spectrum of human character. We need to go back to the '60s and '70s and before, when there was no ADHD. There were no kids who conducted themselves this way. It was unheard of. It wasn’t under diagnosed then, it didn’t exist. And we need to nip the next push in the bud, that there is a whole market for amphetamines to treat allegedly undiagnosed ADHD adults.

The only thing I differ with in this article, is that it gives some credibility to the idea that there are a smaller number of ADHD children who apparently should be on amphetamines. Even this is not true. No one should take speed.

Robert A Berezin, MD is the author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain”

Look up "minimal brain dysfunction".
That is what ADHD used to be called.
Before you start spewing nonsense, PLEASE talk to some neurologists who've been diagnosing and studying ADHD for decades.
Psychiatrists might know a few things about the Mind, but you know nothing whatsoever about the Brain.

I've never read any neurological or neuroscientific journal article that in any way whatsoever proves anything about ADHD. Which specific neurologist's research are you talking about? Which journal was the research published in? I'd like to read that/those studies. "Some neurologists"...sounds like pure bunk to me.

Dear Anonymous,
I am certainly well aware of the old diagnosis 'minimal brain dysfunction'. I was there when that diagnosis was used and it was common knowledge among neurologists and psychiatrists that it had no actual meaning. You might consider that there was no neurological basis for that wastebasket term, any more than there is a neurological basis for ADHD. If you are interested in the brain, you might consider reading my book, "Psychotherapy of Consciousness, the Play of Consciousness in the Theater of the Brain" for a fuller presentation of neuroscience, psychiatry, consciousness, and human suffering.

Please pretend for just a little while that ADHD is real and that the struggles with inattentiveness, procrastination, hyper activity just to name a few can cause a person to feel so overwhelmed and defeated for those who suffer with it so intensely difficult that everyday's reality is waking up hoping that the day hurries up and end and at the same time, hoping it would last just long enough to reach at least a little sense of accomplishment

So I took the good doctors advice and no longer take medications... well at this point I could not afford them or my regular doctor to get them as I lost my job and my partner and my child due to my inability to keep life together anymore!
I am not saying the meds were perfect by any means, but the positive benefits definitely outweighed the negative.
I am very happy that on Jan 1st Obama care kicks in so I can finally see my doctor again so I can get some thing new or the same meds I was on again so I can take some control of my mind again. Even if it is just a small amount, it is definitely better than this!

Mark
I don't what meds you have been on, and I am not asking you in this public forum. Remember, your clinical well being is more important than a blog discussion. I would suggest that many of today's psychiatric med's, particularly the antidepressants are very hard to discontinue. They require careful supervision, and a slow detox that takes a year. Otherwise, due to habituation, symptoms return very powerfully, and it falsely appears that the drugs have protected you and now you are worse off without them. This is a rebound phenomenon. And detox symptoms make many people feel like they lose control over their mind. This comes from detoxing off the drugs, not some underlying condition. I cannot speak specifically to your situation, and I hope things go well for you.

Addie,
I am sorry for your pain. First and foremost treatment for your suffering is more important than any blog article or book. And furthermore you won’t find real answers in a book. I certainly hear your desperation. As I am not in a position to evaluate and treat you, I can only suggest finding a really good therapist. I understand that this is not so easy. If you’ve tried before and it didn’t help, try again. And please, the last thing I would say to you is that you do not bring on these issues. And for you to attend to your well-being is not selfish. Good therapy will help you. And drugs are not the answer. Good luck,
Dr. B

Thanks for sharing Addie. I have been dealing with very similar all of my life, but have suffered through without medication. Instead, I have been jailed and institutionalized from juvenile into adulthood, mainly from drug addiction. Happy to say I am clean 16 years and have found a way to deal in society. I have chosen to be a part of AA and NA as a way to deal with everyday life; so glad to be a recovering addict.

I would agree that the drug companies are going a little crazy and trying to market ADHD as if everyone has it, only for their own profit. However, to suggest that ADHD as a whole does not exist, or that it is merely a result of poor upbringing and lack of proper parenting, is complete bunk.

I have personally struggled all my life, not being able to read until I was 14, could not concentrate on my schoolwork, even though I sat there, for hours upon hours, trying to force myself to. I come from a wonderful family, two parents who love each other and were extremely supportive as well as structured with how they raised my brother, sister, and myself. My sister is extremely bright, straight A's, my brother is an airline pilot, and somehow I cannot seem to EVER focus on ANYTHING that actually needs to get done. I was misdiagnosed as not having ADHD as a child, and was recently diagnosed by a specialist as having ADHD. After dealing with ADHD for 30 years, I have been determined to beat it without drugs if at all possible. I am working with a naturopathic Doctor to bring me to peak health (in my ADHD nature, I completely burnt myself out, fried my adrenal glands, did pancreatic damage due to high sugar/starchy carb intake, etc.), I exercise 7 days a week, I eat all organic veggies and meat, I go to bed at the same time every single night and get up at the same time every single day, getting 8 hours per night, and I have been using HappyLight Deluxe light panels for light therapy to treat my S.A.D. (which in combination with the exercise has helped a lot) and, although my ADHD symptoms have gotten better, I still cannot focus on simple tasks like sending out invoices to my clients, and thus, am completely broke, won't be able to pay my rent in a few days, and then I read your article that is basically saying ADHD was invented? Perhaps the name was invented, perhaps it's over-hyped, perhaps it's over-diagnosed, but I think perhaps you really, really have no clue what you're talking about. I have read book after book after book on ADHD, it's causes, symptoms, and I assure you, Dr. Berezin, you are quite mistaken. Put your ego aside, do some real research, like the many, MANY doctors and researchers mentioned in published books on ADHD, and you might realize that telling people like me who can barely handle basic tasks in life that, essentially, this is all our fault, and our own doing/family's poor parenting skills, is not only wrong, but it is harmful, hurtful, and disempowering. Do a search on PubMed, look at the SPECT, EEG, EKG, and fMRI brain scans comparing ADHD brains to normal brains. It is CLEAR that our brains are lower or higher functioning in the areas correlating to our symptoms.

To anyone else reading this, ADHD is very real. However it is much more complex than any simple diagnosis can make, and must be handled with a professional who knows that there are many different types of ADHD, not just two.